Chapter 17: Cardiovascular Emergencies

Overview

• Focus on cardiovascular emergencies in emergency care.
• Understand anatomy, physiology, pathophysiology of the cardiovascular system.
• Recognize common cardiac conditions and learn the use of AEDs.
• Essential skills for patient assessment and management in scenarios.

Importance of Cardiovascular Health

• Leading cause of death since the 1900s: Cardiovascular disease.
• EMS role in reducing deaths:
  • Encourage healthy lifestyles.
  • Early medical access.
  • Increase CPR training.
  • Use technology in dispatch and cardiac response.
  • Public access to defibrillation.
  • Advanced life support and specialty centers.

Cardiovascular Anatomy and Physiology

Heart Structure

• Heart: Pumps blood; divided into left and right sides.
  • Atrium: Upper chamber receiving blood.
  • Ventricle: Lower chamber pumping blood.

Blood Flow

• Blood exits through one-way valves.
• Aorta: Main artery receiving and delivering blood.
• Coronary Arteries: Supply blood to the heart muscle.
• Arteries & Veins: Distribute oxygenated blood, return deoxygenated blood.

Electrical System

• SA Node: Generates impulse; coordinates heartbeats.
• Atria to Ventricles: Conduction pathway.

Autonomic Nervous System

• Sympathetic & Parasympathetic: Regulate involuntary functions and heart performance.

Pathophysiology of Cardiovascular Conditions

Ischemic Conditions

• Ischemia: Decreased blood flow to the heart.
• Atherosclerosis: Plaque in arteries causing occlusions.
• Thromboembolism: Floating clot causing blockages.

Heart Attacks and Related Conditions

• Myocardial Infarction (MI): Heart attack due to blood flow obstruction.
• Angina Pectoris: Temporary oxygen shortage causing chest discomfort.
• Signs/Symptoms of MI:
  • Chest pain/discomfort.
  • Weakness, nausea, sweating, irregular heartbeat.
  • Shortness of breath, possible CVA.

Cardiac Dysrhythmias

• Premature Ventricular Contractions (PVCs): Extra, usually harmless beats.
• Tachycardia and Bradycardia: Abnormally fast or slow heart rates.
• Ventricular Fibrillation: Requires defibrillation; cessation of effective heartbeat.
• Atrial Fibrillation: Irregular, rapid heart rate.

Other Cardiac Conditions

Cardiogenic Shock

• Caused by heart's inability to pump blood effectively; organ malfunctions.

Congestive Heart Failure (CHF)

• Pulmonary edema from heart failure; fluid builds up in lungs.

Hypertensive Emergencies

• High blood pressure causing severe headaches, possible strokes.

Aortic Aneurysm

• Weakness in aorta wall, may rupture; causes immediate life-threatening bleeding.

Patient Assessment in Cardiovascular Emergencies

• Scene Size-Up: Secure safety, identify nature of illness.
• Primary Assessment: Check responsiveness, breathing, and circulation.
• History Taking: Sample history, allergies, medications, prior heart issues.
• Secondary Assessment: Vital signs, focus on cardiac and respiratory systems.

Emergency Medical Care

For Chest Pain

• Ensure comfort; give oxygen as needed.
• Administer aspirin and nitroglycerin per protocol.

Use of AEDs

• Key for patients in cardiac arrest.
• Follow protocol for attaching and using AEDs.

Post-Resuscitation Care

• Monitor vitals; ensure oxygen levels are adequate.
• Prepare for transport, follow local protocols.

Conclusion

• Review key concepts and ensure understanding of cardiovascular emergencies.
• Practice skills regularly to ensure readiness in real scenarios.